Internet Gaming Addiction (Video Game Addiction)

Internet and Video Gaming Disorder
 
Although not currently an official diagnosis recognized by the APA’s DSM 5 TR, internet gaming disorder (video gaming addiction) is included in the section: Conditions for Further Study. The proposed features of internet gaming disorder include a preoccupation with internet or video games, withdrawal symptoms when internet gaming is not available, observable tolerance to gaming (the amount of time needed to feel pleasure from gaming increases, leading to longer gaming sessions), and difficulty controlling the amount of time spent gaming (APA, 2022, p. 913). Additional features include loss of interest in other activities, excessive use of gaming despite being aware that it is an issue, lying about the amount of time spent gaming, using gaming to escape negative feelings, and gaming damaging relationships, jobs, or education/career (APA, 2022, p. 913-914).
 
While much of the research on this potential disorder comes from Asian countries (South Korea has declared this issue a public health threat), recent research supports that video gaming addiction is a significant concern in America and other Western countries as well (APA, 2022, p. 914). The estimated mean prevalence of internet gaming disorder in the United States over 12 months is approximately 1%. Meaning that, on average, nearly 3.5 million people in the US would meet criteria for internet gaming disorder (APA, 2022, p. 915). This proposed disorder appears to be more prevalent among adolescent and young adult men, and the data also suggest that young men are more likely to play games with a higher potential for addiction (APA, 2022, p. 914). This author would like to note that these numbers may be skewed because gaming has traditionally been marketed more heavily towards young men.
 
Since internet gaming disorder is not an official diagnosis, this section will not focus on the best treatments or tips. Instead, the author will offer reflections and anecdotes as a clinician who also enjoys online gaming. I believe it is likely that internet gaming and non-internet gaming addiction will continue to increase in prominence for several reasons. Firstly, the male loneliness epidemic seems to be increasingly driving young men to withdraw from social relationships and to spend more time isolated online. This can be seen in the rise of incel culture and, more broadly, the “manosphere” – that is a topic worthy of its own blog/discussion.
 
In my experience as a clinician, I have encountered many isolated young men who very much desire more real-life relationships but either lack the skills or confidence to find them. It is much easier for these individuals to remain within the safety of their online worlds than to enter an unfamiliar and scary setting, such as a public space, and risk experiencing embarrassment or ridicule. Often, these young men spend so much time online interacting with other young men who may also have social skills deficits that the social interaction they do get leaves them unprepared to interact with others who are not terminally online or participants in “gamer culture”.
 
Lastly, I would like to highlight how some video game companies have intentionally introduced addicting elements into their games. “Loot boxes”, “battle passes”, and other features introduce gambling elements, FOMO (Fear of Missing Out), and other strong incentives to be spending as much of one’s time on a game as possible. In fact, some modern games essentially operate as glorified Skinner boxes (a box designed to administer rewards to reinforce a desired behavior) that shower the player with flashing lights and music for acquiring a rare item or leveling up. This can also create a social comparison aspect since players can show off their high-level or rare items to others, which further incentivizes spending more time in the game to obtain these rewards.
 
Similarly to what we’re already seeing in South Korea, I would not be surprised if internet gaming disorder is eventually declared a public health concern in the US. Even though it is not an official disorder… yet, I would highly encourage people who are worried about a loved one who spends too much time gaming to seek help through therapy. I would be happy to help you or a loved one navigate through these challenges in a supportive environment.
 
By Gabriel Macfee, LCP, LMLP

Gabriel believes firmly that therapy should promote growth in both the client and practitioner, so he is always focused on learning and working.
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Works Cited
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association.

Photo by Alex from Calgary

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